Change is never easy.

I know how fast information travels these days, so you have probably heard about the changes coming. I want to take a few moments to convey the truth for myself, as well as to share both the joy and the multitude of puzzling emotions that go with any change. To get to the point (something I’m not famous for doing), I will be leaving Santé in June. Yes, it’s true -- my time there has come to an end. This is the culmination of nearly eighteen months of confusion, challenges, resistance, mediation and bargaining. I am going to make a change.

SantéCenter for Healing has been a part of my life since before it opened. My journey into psychiatry began, primarily, because I was told I could NOT join Rip and Deb Corley in their work at Millwood Hospital in Arlington, Texas. The reason: I was not a psychiatrist. Soon afterwards, the Corleys left Millwood and settled into Charter Hospital of Dallas, alongside the Trauma Program run by Dr. Colin Ross. Being able to look to two of my favorite areas of work, led by experts in the same building, was a tremendous opportunityfor me, as I entered my residency.

Two months before I was to migrate to Dallas to complete the last two months of my psychiatry training in these two programs, Rip called to tell me that the contract had been cancelled; a big chain like Charter could no longer treat .” My plans were already in place, and I had procured my license, so I headed to Dallas anyway. I bunked in the spare room at Rip’s Dallas home. Many evenings were spent on parallel sofas, watching TV. I watched as Rip mused over a real estate prospectus on a place called “The Argyle.” It was a dream of his. A little over a year and a half later, that property would become SantéCenter for Healing and Rip’s dream would begin to come true.

Much has changed in the nearly fifteen years that have followed. I remember fondly those days of three or four patients, and of moving to that first magic hallmark of eleven patients. What a celebration that was! After roughly eighteen months as the first Medical Director at Santé, my time to move on came about. For the next four years, I followed my heart and the path ahead of me through three hospitals and back to Millwood, where it all started.

In 2002, I became intensely aware that my time of AcuteInpatientHospital work was about done (probably way past “about” done!). I bid farewell to that chapter in my life and walked away with the fulfillment of one dream, towards another. Early in 2003, Rickey Dovers and Dennis Wade had dinner with me to discuss the possibility of joining the Santé Team again, directing the development of an Eating Disorders program. It sounded pretty workable -- I began visiting Santé two half days a week. The next spring, Dr. Richard Prather migrated out of Santé, leaving a vortex that pulled me into not only the Medical Directorship, but also into the leadership of the Professionals Program. No longer filling a ten to twelve hour a week position, I began to make the trip to Santé three times a week. The split became too much and, in 2008, I closed my office in Dallas and finished my transplantation to Argyle.

During the last fifteen years, I have learned to present in PowerPoint and traveled to multiple conferences a year, usually presenting something at the majority of them (me and my big mouth!) In the process, I found that I had learned a few things that others wanted to share. I was now an “expert.” (Expert defined as "Having a PowerPoint presentation and being more than 50 miles from home!) I have been forced to learn to do so many things, many of them things I never realized I never thought I could do.

Santé has changed a lot in the last eight years. We have gone from a center with an average census in the lower twenties to an average census in the upper thirties. In fact, there have been times when all forty-six beds have been filled, and we had a waiting list. Rip “retired” and placed the program in the hands of the management team. In this process, Deb (at Rip's direction) challenged Ron and me to fill the gap. Since that challenge, Rip passed away. He took with him encyclopedic knowledge of what Santé does and how to do it, but The Team has picked up the ball and run with it. Santé has become more than any of us dreamed. As I look back on my journey to make a decision to leave, I see how much I have been torn between doing something I absolutely love to do with remarkable people, spending therest of my career with ease and comfort, as opposed to daring to look at a new vista, and a broader, uncharted horizon.

Somewhere in the last few years, a subtle tide began to turn. For several years, at the advice of some people I trust explicitly, I have answered calls from “head hunters” in psychiatry. This has allowed me to practice interviewing for a job – something I had NEVER done in my entire career. In 2010, more than a couple of offers began to raise new questions. One changed my thinking. This involved the request to envision my career in five years, and say what I would really like to have accomplished. Without permission, my mouth spoke a Truth I had not really embraced – “I would like to have taught five people what I know and how to do what I do.”
Suddenly, my entire horizon changed, forcing me to think in new terms and to see from a new perspective. I wanted to write, to teach and to grow within myself. I joined with Santéand with our best effort, these results didn't materialize. I found one consistent problem - I had woven myself into virtually every aspect ofSanté. The more I pulled back, the more I found I did not know how to remove my time and energy from any single part of the process. At this point, the prospect of letting go completely and starting again elsewhere became enticing.

That horizon began to broaden with the invitation by Dr. Carnes to translate my “sermon” on Post-Acute Detox and Detox as a Physiological Process into a workbook for people struggling with the first phase of Detox. While closely related, his offer has been independent of the invitation to explore a new career move, and that creation is still in process. As the option to begin a new venture became real, I was approached by PineGroveHospital to consider working with them. The possibility of working in tandem with Dr. Carnes and the staff there, initially, had a bit of a magical allure. Playing on that, the process began though it could not entice me to consider more than a passing fantasy in that iteration. As the year progressed, however, their interest became more intense and the opportunity began to become more feasible and to show some possibilities I had not considered. After some intense work and a long standoff, the fantasy began to materialize.

Beginning late in June, I will begin to “commute” to Hattiesburg, MS to begin my venture with PineGroveHospital and the Gentle Path Program. One of the aspects of this change that has drawn me is that, free of the responsibilities of the Medical Directorship, I will be able to embrace the task of creating new components of the program with the staff, helping to publish the data they have gathered there. While I will spend the majority of time with the program treating sexual addiction, I will continue to treat chemical dependency and other addictive processes, since my true “love” is the poly-addiction model – “An addiction is an addiction is an addiction.” I will spend three days a week in Hattiesburg, committing another significant period each week to writing and program development. The remainder of my time will be focused on work I have had on the back burner. All this, while doing what I enjoy!

This has not been an easy decision. I am aware that it stands to create a huge upheaval in my life. After all, my life has been well-contained in many ways for much of the time I’ve been at Santé. However, just as my thumbprints are all over it, Santé has become woven into the fabric of my life. I have had the gift of walking sacred journeys with incredible people, and being handed trust that goes beyond words. Santé has been the platform for me to grow and develop personally, as well. I can never express the depth of gratitude to the Corleys (and George Straw), the staff with whom I’ve had the pleasure of working, and, most of all, the patients who have touched my life and my heart in so many ways.

I am leaving Santé as it turns a page in its own history. Change and growth have been afoot for some time. I deeply grieve leaving before the physical expansion and program growth are completed. The staff has not yet finished fully integrating the hours and days of training in the CSAT course and its nuances into the program. The experience of that training has been an amazing one for all of us. New people, new programs, and new processes that will make huge differences in the already strong and successful treatment program at Santé are moving into place. These things will be the “bar” against which my future will be measured. That will not be easy for others!

No doubt, many conjectures and assumptions will be conjured up from the ethers. Most of them will be very entertaining and far from the truth. I am making this move because it is the "blinding flash of the obvious" in terms of my future. This has been a pairing of tremendous excitement and possibility with a huge sense of loss. However, this has been one filled with a very deep sense of serenity. I have been challenged by my life to actually DO all those things I preach, such as surrender, ask for help, and relax and take a deep breath while I wait for the answer. They truly do work.

At the end of March, the weekend of the “Supermoon,” I went to one of my favorite places – Golden Willow Retreat in Arroyo Hondo, NM. I asked my good friend, Ted Wiard, to let me be there to be in a spiritual place to listen quietly. I had an unsigned contract from Pine Grove and a lunch date with Deb. One of those two would end the weekend in disappointment. With the help of a bit of silence, a prayer labyrinth, and a Native American time of prayer and contemplation, I was able to find clarity in my heart. Shortly thereafter, I stumbled on a quote by Anaïs Nin: “And the time came when the risk to remain tight in a bud was more painful than the risk it took to blossom.” (I never cease to be amazed when the “answer” lands in my lap, if I have the wisdom to simply sit with a question!)

I will not be disappearing. I will, of necessity, make some dramatic changes in my private practice. I will continue to live in Denton and to have my anchor here with my family and friends. Unfortunately, bilocation has not become a skill of mine. Thus, the reality is clear that I will have to let go of some things on which I have had a vice grip of control. I will be discussing with any and all my patients how that can and will affect their continued care. I know many of you have heard me say, “I’m grandiose enough to think that I do it better than anyone else, and realistic enough to know that this is not true.” Those words are haunting me these days! Regardless, I want exactly what I hope I’ve provided – that each patient continue to have the very best possible treatment and care. We will find the new version of that care.

In closing, I want to be sure that I have thanked each and every person who has entrusted their bodies, minds, and souls to the treatment process of which I have been a part. You gave me trust, when I had not earned it. You allowed me to share in your journey into places you had either never been or had sworn you would never go. Without knowing it, you embraced the notion that I could walk through that dark place with you, and that we would both come through touched only by healing. My time at Santé has been an unbroken series of very special journeys, some of them miraculous and all filled with gifts along the way. I can never express my true gratitude. In the words from Wicked:The Musical, "youwill truly be with me,

“like a handprint on my heart….

and whatever way our story ends,

I know you have rewritten mine,...” by being a part of my life.

Please stay in touch and keep me posted about the ups and downs of your lives.

Enough IS Enough

Ronald is a very talented man. He has had a line-up of careers that many would envy (and from which some would run like the wind). He first came to see me at a turning point in his career -- he had no reason not to be successful, but seemed to be perched on the brink of doom at any moment in time. Being rather bright, the "therapy" part of his treatment become quick work. Over the months and years, despite seeming to continue to stumble and "splat" over success, he managed to nurture his romance into one most would admire and even express jealousy over. He joined a company that was hurting and helped it heal and become successful. His free time was filled with travel and writing and all sorts of fun things. After that, his visits were rapid updates that led to the "issue" or "problem" for which an "answer" was sought. It always seemed as if he handed me some phrase or concept that I could "tweak" just a tiny bit and hand back to him and which would become "THE ANSWER."

So what was so wrong this time? When Ronald came in for his "15,000 mile checkup" as he called our 3 or 4 times a year sessions, he told me he was looking to see if anything was really wrong. As he described the the wonderful trip to another continent which he had taken with family (complete with pictures that were perfect), he beamed with glee. As he talked about the time he spent roaming the streets of a foreign land meeting new-found old friends, he became more and more ebullient. Almost out of the blue, his lilting joy came to an abrupt halt as he said, "I'm scratching things off the list as fast as I can."

I paused to let the moment settle into the quiet, half out of not quite knowing what to say and one-quarter out of fearing he was feeling some sort of terminal sense. I finally broke the silence by asking him if that was such a bad thing. He seemed truly puzzled as though he had no idea. We continued to discuss his experiences and he felt as though he was filling with a sense of peace. Each of the things he had wiped from his list were things he swore he would do one day. He had done each of them and had done some for more than one day. Between what he had done and what he had on order to learn, he would have very full hobby time for many months to come. This, for Ronald, was not a bad thing. In fact, it was a source of ecstasy! Out of the blue, came the BS for the moment:

"Enough IS Enough!"

For Ronald, at that moment, not only was HE enough, but each item on his list was Enough. For many of us and for so much of our lives, we save our time, our money, our energy, our "stuff" and everything else for those special things on our "Bucket List" (The things we want to do before we "kick the bucket.") Far too many times, we either do them in a rush, unprepared emotionally or mentally and lament how we need to do them again and do them right. Or, even worse, we put them off until either they are no longer an option (How many of us never stood on the observation decks of the Twin Towers in New York City?) or WE are no longer an option. (My knees won't ever climb Mt. Everest!) Ronald had stared a journey from a very stagnant place in his life where nothing was ever good enough because he found himself to never be good enough. As he wrestled with those demons, he learned to accept himself and to accept his strengths and his flaws. When he last sat across from me, he seemed to really see that HE WAS ENOUGH.

As a result, he ate healthy meals -- which were enough, but not excessive. He traveled and saw sights he dreamed of seeing and soaked up every morsel of every sense of every stop he made. When he moved on, despite wanting to return, his trip was Enough. While he dreamed of going back to these places, what he dreamed was another, new trip, not the one he had already taken-- THAT one was Enough. His time with his closest ones was (most of the time) just enough, leaving room for finding time for more, yet always being a satiating experience. If he was still learning a new musical instrument and needed more practice, the rough tune he could squeeze out was, in itself, Enough. As this realization permeated his being, I had to ask the obvious: "Can you add more to the list?"

The wide-eyed answer joyfully erupted, "YES!" His hopes, his future and his joy seemed to soar.

Enough IS enough!